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Risk factors for toxicity include alcoholism, malnutrition, and the taking of certain other hepatotoxic medications. [1] Liver damage results not from paracetamol itself, but from one of its metabolites, N-acetyl-p-benzoquinone imine (NAPQI). [6] NAPQI decreases the liver's glutathione and directly damages cells in the liver. [7]
Drug-induced liver injury (DILI) is a cause of acute and chronic liver disease caused specifically by medications and the most common reason for a drug to be withdrawn from the market after approval. The liver plays a central role in transforming and clearing chemicals and is susceptible to the toxicity from these agents.
Common side effects during treatment include feeling tired, nausea, reduced appetite, and headache. Low red blood cell count has occurred when co-administered with ribavirin in some cases. [ 3 ] [ 9 ] The most important risks are Alanine transaminase elevation, hyperbilirubinemia, drug resistance development and drug interactions.
Sofosbuvir/velpatasvir in combination with ribavirin is indicated for the treatment of children six years and older or weighing at least 37 pounds with severe cirrhosis. [8] The combination is generally well tolerated. [2] Common side effects include headaches, fatigue, trouble sleeping, and nausea.
The most common side effects are headache, diarrhea, and tiredness. [7] [8] In those with a history of hepatitis B, reactivation may occur. [8] It is not recommended in people with moderate to severe liver disease. [7] Glecaprevir works by blocking the protein NS3/4A protease, while pibrentasvir works by blocking NS5A. [4]
Chronic hepatitis C is a major cause of liver cirrhosis and hepatocellular carcinoma. [131] It is a common medical reason for liver transplantation due to its severe complications. [131] It is estimated that 130–180 million people in the world are affected by this disease representing a little more than 3% of the world population.